低强度激光联合照射口咽部和犊鼻穴对实验性膝骨关节炎兔氧自由基代谢的影响

背景：目前激光照射治疗膝骨关节炎以局部照射为主、输出功率和信号较为单一，多次照射易产生生物适应而降低疗效。 目的：探讨携带有针灸补泻信息的低能量激光联合多部位照射对实验性膝骨关节炎兔血清和滑膜组织中氧自由基代谢的影响。 方法：向兔膝关节腔内注入木瓜蛋白酶制备兔膝骨关节炎模型。穴位照射组和联合照射组分别以低能量激光单独照射犊鼻穴或联合照射口咽部及犊鼻穴，10 min /d，5 d为1个疗程，连续3个疗程。参照试剂盒方法测定血清一氧化氮、丙二醛水平和超氧化物歧化酶活性及膝关节滑膜组织丙二醛水平和超氧化物歧化酶活性；苏木精-伊红染色观察膝关节软骨组织形态学变化。 结果与结论：兔膝骨关节炎后，软骨出现明显的病理损伤，血清一氧化氮、丙二醛水平均显著升高(P < 0.01或P < 0.05)，超氧化物歧化酶活性显著降低(P < 0.05)。经激光穴位照射和激光联合照射后病理损伤有所减轻，血清一氧化氮、丙二醛水平均下降，超氧化物歧化酶活性升高，以联合照射组效果显著(P < 0.05)。兔膝关节滑膜组织中丙二醛水平和超氧化物歧化酶活性变化与血清中相一致。说明低能量激光联合照射口咽部和犊鼻穴能够纠正膝骨关节炎兔氧自由基代谢紊乱，减轻关节软骨细胞结构损伤，其效果优于激光单独照射犊鼻穴。

Effect of low-energy laser irradiation at oral pharynx and Dubi acupoint (ST35) on metabolism of oxygen free radicals in rabbits with knee osteoarthritis

BACKGROUND: At present, laser irradiation, especially local irradiation, are used for treating knee osteoarthritis. But it has limitations in output power and signal, which easy to produce adaptation and reduce the efficacy after repeated irradiation. OBJECTIVE: To explore the influence of the low-energy laser irradiating at acupoint or at low-energy laser multiple areas united irradiation on the metabolism of oxygen free radicals in experimental rabbits with knee osteoarthritis. METHODS: Papain solution was injected into articular cavity of rabbits to prepare knee osteoarthritis models. Low-energy laser irradiating at Dubi acupoint (ST35) or at oral pharynx and Dubi acupoint (ST35) was applied for 15 days, 10 minutes per day. The serum levels of nitrogen monoxidum (NO), malondialdehyde (MDA) and synovium superoxide dismutase (SOD) were detected. Hematoxylin-eosin staining was performed to observe histomorphological changes of knee cartilage tissues. RESULTS AND CONCLUSION: Compared with the control group, the contents of serum NO and MDA elevated significantly in the model group (P < 0.01 or P < 0.05), and SOD activities were decreased significantly (P < 0.05). The pathological damage mitigated after laser irradiation, NO and MDA levels were decreased, and SOD activity was increased, especially in the united irradiation group (P < 0.05). The changes of MDA levels in synovial tissue of joint was the same as serum SOD contents. Low-energy laser irradiation at oral pharynx and Dubi acupoint (ST35) can correct oxygen free radicals metabolic disorder and reduce structure damage of articular cartilage, which achieve superior results to irradiation at Dubi acupoint in treating knee osteoarthritis.